Anisakis Simplex Infestation and Immune-Mediated Responses

Nowadays Anisakis simplex (A.s.) infestation is underestimated and underdiagnosis, as the correlated clinical pictures suggest differential diagnosis of the majority of gastrointestinal internal pathologies and of various symptoms of allergic diseases, including the most severe and potentially fatal form represented by the anaphylactic shock. However we must cope with a pervasive and emerging disease which causes public serious health problems.

A. is a zoonotic disease caused by parasitic nematodes of the marine Anisakidae family; the infection is caused by consuming raw parasitized fish. The experimental data in our possession suggest that A. can determine different kinds of immunopathogenesis, in particular the I, III and IV type. From the immunophlogistic point of view a conspicuous eosinophilic infiltration is realized around the implant site tissue of the A. larva, as a result of the action of chemotactic factors released by T lymphocytes, mast cells, basophils, and also by the same A. It usually does not result into a blood eosinophilia.

Keywords: Allergens, allergic diseases, anaphylactic shock, acute gastric anisakiasis, acute intestinal anisakiasis, Anisakis simplex, basophil activation test, chronic intestinal anisakiasis, eosinophils, eosinophilic granuloma, immunopathogenesis, infestation, larvae, mast cells, nematodes, proteolytic enzymes, T lymphocytes, tropomyosin, urticaria, zoonotic diseases.